Recently, I started researching hair transplant surgery, and I’ve become nervous about the possibility of scalp necrosis from the procedure. Is this a common problem? What exactly is necrosis? What causes scalp necrosis from hair transplantation?

Necrosis simply refers to tissue death caused by insufficient blood supply to an area of tissue.

In hair transplant surgery, I can think of several different scenarios where scalp necrosis specifically (and not necrosis or death of the newly implanted grafts) could occur:

Each of the above scenarios would require very specific situations that actually lead to scalp necrosis.

In the FUT example, the strip excision site would need to be closed tightly enough to actually “clamp off” blood vessels and suffocate certain areas of the donor region. This excessive strangulation of the critical blood supply would cause progressive damage and eventual tissue death (necrosis). In the FUE scenario, excessive graft extraction would need to damage enough superficial blood vessels to destroy blood supply to the non-extracted donor tissue. In the “over packing” example, follicular unit grafts would need to be implanted at such a high density that they overwhelm the blood supply and suffocate the rest of the scalp.

Rates of tissue necrosis in hair transplant surgery appear quite low. Although I don’t have the exact figures, most of the cases I’ve seen have been in academic hair restoration textbooks. Altogether, hair transplantation is a very safe procedure, but it’s important to remember that all surgical treatments possess inherent risks. Furthermore, it’s important to thoroughly discuss these issues with your hair restoration physician before the procedure, and ensure all the risks and benefits are fully understood!